Understanding Infertility

The medical definition of infertility is failure to achieve pregnancy in one year of regular intercourse without contraceptives. Pregnancy is the result of a chain of events that occurs in a woman’s body. She must release an egg from one of her ovaries, and the egg must travel through a fallopian tube toward her uterus or womb. A man's sperm must join with the egg along the way, and the resulting fertilized egg must attach to the inside of the uterus. Although this process typically occurs naturally, many things can happen to interfere with pregnancy.

Contrary to popular belief, infertility is not always the woman’s problem. About one-third of infertility cases are due to problems with the male, such as low sperm count, inability of the sperm to reach the egg or no sperm production at all (sterility). Female factors account for another third of all cases. One of the most common factors is ovarian dysfunction, which can result in infrequent or absent ovulation. Polycystic Ovary Disease (PCOD) is the most common female reproductive disease. Fallopian tubal damage, whether caused by infection, complications from a tubal pregnancy, a previous tubal ligation or scarring from gynecological surgery, is also a major factor in female infertility. Endometriosis is another very common cause of infertility.

In other cases of infertility, a combination of male and female factors may be the cause, and in some instances, a cause cannot be identified. Research shows that a woman’s age plays a significant role in her ability to become pregnant. A woman in her 20s has an 80 to 90 percent chance of conceiving within a year. Once she turns 30, her chances begin to decline. After age 35, there is an accelerated drop in a woman's fertility.

Testing for Infertility

If a couple has been trying for a year to have a baby without success, consulting with a specialist could be very helpful. Age is a critical factor in infertility, and if the woman is 36 or older, consultation should be considered after just six months of infertility. There are a number of tests that can be performed to determine the cause of a woman’s infertility. The process typically begins with physical exams and obtaining the medical and sexual histories of both partners. If it appears the couple is timing intercourse properly but no pregnancy has resulted, diagnostic testing is done. It is important to determine whether or not the woman is ovulating each month. There are several ways to test for ovulation. For a man, semen can be examined to determine the number, shape and movement of his sperm. In the laboratory, very sophisticated diagnostics are available to assist in pinpointing the cause of infertility. Depending upon the results, additional screenings may be performed.